Sex therapy

Overview

Sex therapy is a type of psychotherapy — a general term for treating mental health problems by talking with a mental health professional. Through sex therapy, you can address concerns about sexual function, sexual feelings and intimacy, either in individual therapy or in joint therapy with your partner. Sex therapy can be effective for individuals of any age, sex or sexual orientation.

Sex therapy is usually provided by psychologists, social workers, physicians or licensed therapists who have special training in issues related to sex and relationships. Certified sex therapists have graduate degrees and can demonstrate their competence in sex therapy by becoming credentialed by the American Association of Sexuality Educators, Counselors and Therapists (AASECT).

Certified sex therapists do not have sexual contact with clients, in the office or anywhere else. Sexual coaching that involves physical contact is not part of mainstream sex therapy.

Sex therapy is usually short term, with a limited number of sessions. The treatment plan depends on the concerns to be addressed.

Why it's done

Sex therapy can help you resolve various sexual issues, from concerns about sexual function or feelings to the way you relate to your partner. Through sex therapy, you may focus on issues such as:

Concerns about sexual desire or arousal

Concerns about sexual interests or sexual orientation

Impulsive sexual behavior

Erectile dysfunction

Ejaculating early (premature ejaculation)

Difficulty with sexual arousal

Trouble reaching orgasm (anorgasmia)

Painful intercourse (dyspareunia)

Intimacy issues related to a disability or chronic condition

Concerns regarding past unwanted sexual experiences

How you prepare

You can ask your primary care provider for a referral to a sex therapist, or you might check with a local hospital or medical center to see whether they have a sex medicine clinic. Your health insurer or employee assistance program may offer recommendations as well.

As another option, you can check with a professional organization, such as AASECT. Or look on the professional organization websites of psychologists, licensed clinical social workers and psychiatrists to locate a licensed and qualified provider of sex therapy.

Before scheduling sessions with a therapist, consider whether the therapist would be a good fit for you. You might ask questions like those below.

Education and experience. What is your educational and training background? Are you licensed by the state? Are you credentialed by AASECT? What's your experience with my type of sexual issue?

Logistics. Where is your office? What are your office hours?

Treatment plan. How long is each session? How often are sessions scheduled? How long might I expect treatment to continue? What is your policy on canceled sessions?

Fees and insurance. How much do you charge for each session? Are your services covered by my health insurance plan? Will I need to pay the full fee upfront?

Before your appointment

Prepare for your appointment by making a list of:

Details of your problem, including when it started, whether it's always present or comes and goes, professionals you've seen, and treatments you've tried and their outcomes

Key personal information, including your medical conditions and any major stresses or recent life changes

All medications that you're taking, including over-the-counter drugs, vitamins, other supplements or herbal preparations, and their doses

Questions to ask your therapist about your sexual concerns

What you can expect

You'll likely begin sex therapy by describing your specific sexual concerns. Sexual issues can be complicated, and your therapist will want to get a clear idea of all the factors involved. Once your therapist understands the situation, he or she will discuss ways to resolve your concerns and improve your communication and intimacy.

Talking about sex and intimacy may initially feel awkward. But certified sex therapists are trained at putting you at ease and are skilled at identifying and exploring sexual concerns.

If you're in a relationship, it's usually most helpful to involve your partner in meetings with your sex therapist. You and your partner may be assigned a series of homework exercises, such as:

Communication exercises with your partner

Slowing down and focusing on what you're sensing during intimate encounters (mindfulness techniques)

Reading or watching educational videos about sexual health

Changing the way you interact with your partner both sexually and nonsexually

Sex therapy is usually short term. Some concerns can be addressed quickly, in just a few visits. Typically, however, several counseling sessions are needed.

As sex therapy progresses, you can use your home experiences to further identify and refine the issues you'd like to work on. Remember, sexual coaching that involves physical contact is not part of mainstream sex therapy and is against the ethics of licensed mental health providers.

Other issues

Keep in mind that concerns about sex and intimacy are often linked to other underlying issues, such as stress, anxiety or depression. In other cases, sexual function is affected by chronic illness, medication side effects, surgery or aging.

Depending on your concerns and your physical health, seeing only a sex therapist may be enough — or your sex therapist may be part of a team that includes your health care professional. For some sexual concerns, medication may be helpful. A complete medical evaluation can help determine the nature of your problem and the treatment options that may be appropriate.

Results

Remember, effective sex therapy requires trust and good communication with your therapist. If you don't feel enough rapport with your therapist to lead to effective resolution of your concerns, consider finding another therapist.